2025 NC Rehabilitation and Reentry Conference - Vendor and Sponsor Registration Submitted by kaacree on Tue, 02/07/2023 - 21:47 Indicates required field Vendor Company Name Vendor Type Community Resource Government Agency Employer Healthcare Provider Products/Services for sale Sponsor Other… Enter other… Vendor Primary Contact name Primary Contact First Name Primary Contact Last Name Primary Contact Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Primary Contact Email Primary Contact Telephone Vendor Representative 1 Vendor Representative 1 First Name? Vendor Representative 1 Last Name Vendor Representative 1 title Vendor Representative 1 email Vendor Representative 1 phone Vendor Representative 2 Vendor Representative 2 First name? Vendor Representative 2 Last Name Vendor Representative 2 title Vendor Representative 2 email Vendor Representative 2 phone Describe any accessibility needs Vendor mission Purpose/goal in attending NC Rehabilitation and Reentry Conference Please describe your organization's purpose or goal in attending the NC Rehabilitation and Reentry Conference. Describe your exhibit Please describe any display items to be used or provided to attendees. Display signs may not exceed 10 feet tall and should fit on or immediately next to assigned 6-foot table. Website/Social Media accounts Please provide any website URLs or social media accounts where we can learn more about your agency
